Not surprisingly, most top resolutions for the coming year remain relatively unchanged from previous years’. They revolve around health, such as exercising more, eating healthier and, for many Americans, quitting smoking. In this country, cigarettes continue to be associated with nearly 500,000 deaths a year from coronary heart disease, stroke, cancers and other illnesses.

As I pointed out last week, my suggested New Year’s resolution is that we do all in our power to halt a new threat to the health of our nation – specifically, of young people – that could dramatically expand those numbers even more.

As widely reported in the last few weeks, vaping, the inhaling and exhaling of vapor from heated cartridges of liquid usually containing nicotine, flavorings and other chemicals has seen the biggest one-year spike of any kind in the 44 years of monitoring of substances used by young people. The total number of middle and high school students using e-cigarettes rose to 3.6 million, an increase of 1.5 million students in one year. Surgeon General Jerome Adams has labeled the situation as “epidemic.” The latest survey also indicates that students may not realize they are inhaling nicotine, a highly addictive substance. Add to that the fact that many teenagers picking up an e-cigarette have never smoked a traditional cigarette, and, now, according to current research, they have become four times more likely to do so.

Though e-cigarettes have been around for a decade or so, health officials and federal regulators have been caught flat-footed by this tidal wave of teenage vaping.

Juul is the biggest and most successful brand name in vaping, accounting for more than 70 percent of e-cigarette sales. Juul also appears to be the major beneficiary of the spike in vaping: The company saw a 600 percent surge in sales from 2016 to 2017. According to an NPR report, a typical Juul cartridge contains about as much nicotine as a pack of 20 regular cigarettes, closely matching tobacco cigarettes in terms of the speed and amount of nicotine delivery. Juul does not currently offer nicotine-free flavors.

The addictive nature of nicotine is at the center of this cause for alarm. While nicotine is not known to cause diseases such as cancer, it is a stimulant and a sedative that releases dopamine in the brain’s pleasure centers. This chemical in both tobacco and e-cigarettes binds the user to the product. At its worst, it can create an addiction where some lose their capacity to make a free choice.

The recent announcement by Altria, the leading U.S. cigarette manufacturer and parent company of Philip Morris, should make clear the nexus between traditional cigarettes and e-cigarettes. Altria recently announced it is making a $12.8 billion investment in Juul and plans to aggressively help promote the brand. As noted by Robin Koval of the Truth Initiative, an organization set up to counter decades of tobacco industry marketing, Big Tobacco just got bigger. The investment gives the tobacco industry a new, direct pipeline of millions of young e-cigarette users.

As part of the deal, Juul now can access Altria’s valuable retail shelf space, with its products to be sold alongside major cigarette brands. Even more worrisome is the fact that it connects Juul to Altria’s powerful lobbying and regulatory force.

“No one is as expert at manipulating the regulatory process and creating obstacles to public health as Altria is,” David Balto, a former assistant director of policy at the Federal Trade Commission and now an antitrust lawyer in Washington, told NBC News.

The Federal Trade Commission has said it intends to create new regulations requiring traditional cigarette makers to reduce the amount of nicotine in their products. The Food and Drug Administration also has plans to seek further regulation of tobacco products, including e-cigarettes, and to ban menthol cigarettes. And the FDA has moved forward with restrictions on sales of sweet-flavored electronic cigarette liquid. The battle between tobacco and health is about to take a new turn.

Flavoring masks the harshness of tobacco smoke, making it easier for people to start smoking. A ban on menthol, in particular, has long been sought by public health authorities and antismoking advocates. Flavors are a primary reason for young people to use e-cigarettes. Adult users seem to prefer non-tobacco flavors as well. Many teens say they are inhaling “just flavoring” when they vape, meaning they likely don’t realize they are inhaling high levels of nicotine.

As current studies have shown, young people today are already stressed out. It should not be surprising that mental health disorders like depression and anxiety, as well as use of other substances, are common in kids trying to kick their nicotine habit.

At this point, we cannot legislate our way out of this problem. It is now a social issue, and we need to try to see e-cigarettes from the perspective of teenagers. Many forces are at play in compelling a kid to vape.

“The trick is not to try to scare them, because scare tactics don’t work at this point,” Dr. Suchitra Krishnan-Sarin, a Yale professor of psychiatry who focuses on adolescent behaviors and tobacco products, recently told The New York Times. “But explaining how these products are making them addicted is the way to go.”

Most kids know better than to smoke cigarettes. The health implications are now undeniable. Plus, it is no longer a “cool” thing to do. The goal is to encourage kids to quit vaping for their own good – which will be easier said than done.